8 Things to Know before having Rhinoplasty

Posted on Friday, April 15th, 2016 by RichardZoumalan in category Blog, Rhinoplasty

Cosmetic surgery is foreign territory to most patients and can be intimidating to consider initially. After performing thousands of rhinoplasty procedures, I have found the key to combating this fear is education; knowledge is power. For this reason I have found these questions to be important when considering the correct path in pursuit of surgery.

1.     Determine what your goals are. Do you want your bump gone? Do you want a narrower nose? Do you want your tip lifted? You want to develop a sense of what your biggest complaints are. The surgeon will be best able to help you if you can clearly tell him or her what bothers you the most.

2.     Find the right surgeon for you. You want to know the surgeon’s Board Certification and specialty. There are two main specialties that perform Rhinoplasty. One is Board Certification through the American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive Surgery. These surgeons have training in Ear Nose and Throat surgery as well as Facial Plastic and Reconstructive surgery. They have training in both the inside (breathing) and outside of the nose. The other category of surgeons who performs rhinoplasty has Board Certification through the American Board of Plastic Surgery. These surgeons have been trained to perform plastic and reconstructive procedures on all body parts. While there are excellent rhinoplasty surgeons in both groups, you should seek out a surgeon who performs rhinoplasty regularly and is involved in research and academic aspects of rhinoplasty. This shows dedication to the art of nasal surgery. Rhinoplasty is very complex, and it requires someone who  is focused on it. After this, it comes down to choosing the surgeon whose goals fit with yours. Of course, you also want to be comfortable with your surgeon.

3.     There are surgeons who perform imaging of the nose. Imaging the nose can give you an idea of what your nose could look like after surgery. It is not a guarantee of results, but it is a great communication tool. You and the surgeon can work together to discuss whether certain maneuvers will make your face look better. There is now 3-Dimensional imaging which can really give you a further idea of what things can look like from many dimensions. However, because the nose can heal in various ways, the imaging is not a true predictor of the final result

4.     Rhinoplasty can affect breathing. The surgeon needs to ensure that internal breathing issues are addressed during rhinoplasty. Half the reason why people seek revision rhinoplasty can involve breathing difficulties after surgeries. The surgeon needs to be aware of these issues. Dr. Zoumalan published an article on the potential to improve breathing during rhinoplasty (Reference Article here  Zoumalan, Constantinides. Objective Improvement in Breathing after Rhinoplasty)

5.     It takes one year to see the final result of rhinoplasty. Nasal tissues take time to heal. Even though you may have your bump gone after the first week, you still have healing to do. You have to be patient to see the full thinning out of the nose. This can take a year or longer.

6.     There are two approaches in rhinoplasty: Open versus Closed. Open technique uses a very small incision between the nostrils which heals very well. There has never been a keloid scar of this area, and patients heal very well here. Open approach can allow for more exposure for the surgeon to do complex tip and middle nasal work. The closed approach is all done from the inside and does not use the incision between the nostrils. Both approaches can have excellent results. The result depends more on the surgeon rather than whether it’s an open or closed approach.

7.     Look at before and afters. Different rhinoplasty surgeons have different styles. Some prefer a lower dorsum or “scooped” look. Other surgeons prefer a stronger bridge with a more natural look. Some surgeons prefer tips that are more turned up. Surgeons tend to have different aesthetic goals, as there is no “perfect nose.”

8.     There is no “perfect nose.” During one of his speeches before he retired, Dr. Jack Gunther stated that he never saw a perfect nose. Rhinoplasty can help improve noses dramatically and make you much happier. However, it is important to note that minor imperfections are common, but usually match the new nose in a harmonious way.